CLOSED-LOOP CONTROL OF FLUID RESUSCITATION VIA BLOOD VOLUME ESTIMATION

This paper presents a model-based approach to the closed-loop control of fluid resuscitation against hypovolemia. In this approach, the control system consists of a model-based blood volume estimator and a feedback controller The model-based blood volume estimator derives relative changes in the blood volume response to the augmented fluid by analyzing an arterial blood pressure waveform and the electrocardiogram. Then, the feedback controller determines the amount of fluid to be augmented by comparing targeted versus estimated relative changes in the blood volume. In this way, unlike many previous methods for fluid resuscitation based on indirect surrogate(s) of blood volume, fluid resuscitation can be directly guided by the blood volume response. This paper reports initial design of the closed-loop control system and its simulation-based evaluation in a wide range of hypovolemic and physiologic scenarios. The results suggest that the proposed closed-loop control system is very effective in resuscitation against hypovolemia: in 97 out of 100 simulated hypovolemia, the final blood volume achieved by the control system was within 10% of its optimal value.